Abstract
Postoperative paralytic ileus follows all significant gastrointestinal surgery. Its duration is variable and has led to a variety of empirical and time-consuming oral fluid regimens. We have compared a traditional method of fluid administration with an unstructured, simpler, patient-determined approach. A series of 102 patients on a general surgical ward who required intravenous fluids on the day after surgery were randomised by a closed envelope system to one of two protocols and followed prospectively. Of these, 12 patients were erroneously randomised or unable to fulfil trial requirements. The first, 'regulated' group (n = 41) received hourly aliquots of oral fluid as determined by twice daily ward rounds according to ward routine. The second, 'unregulated' group (n = 49) were given a jug of water and instructed to drink as desired. Patients in the regulated group received less of their postoperative fluids by the oral route at all stages of recovery but there were no significant differences in the mean durations of intravenous therapy, nasogastric intubation or hospital stay. Postoperative complication and mortality rates were also similar. Patients who underwent gastric or duodenal procedures (n = 14) showed a similar pattern of results. We conclude that 'patient-determined' regulation of postoperative oral fluid intake is safe and effective and may greatly simplify ward management.
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Selected References
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- Key J. C. Healing of anastomotic leak with transanastomotic enteral feeding. Tex Med. 1981 Jul;77(7):43–44. [PubMed] [Google Scholar]
- Muir I. F. Maxillary development in cleft palate patients with special reference to the effects of operation. Ann R Coll Surg Engl. 1986 Mar;68(2):62–67. [PMC free article] [PubMed] [Google Scholar]
- Rando J. T. Fluid and electrolyte management of the adult surgical patient. AANA J. 1982 Feb;50(1):49–54. [PubMed] [Google Scholar]
- Shires G. T. Postoperative, post-traumatic management of fluids. Bull N Y Acad Med. 1979 Feb;55(2):248–256. [PMC free article] [PubMed] [Google Scholar]
- Underwood P. S. Fluid management in the recovery room. Int Anesthesiol Clin. 1983 Spring;21(1):43–58. doi: 10.1097/00004311-198305000-00005. [DOI] [PubMed] [Google Scholar]